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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />, Building Department <br /> <br />hi 181€ <br /> <br />Fax-813-780-0021 <br /> <br />Ie; rJ./. SI <br /> <br /> <br />Date Received <br /> <br />5-( 3- <br />LesLIE ,4. AAlf)~~s~H -65~e,'<:> -J~ <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address I SO 3 ~ <br />Fee Simple Titleholdlilr Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS I S'.A-Jn~ <br /> <br />I <br /> <br />SUBDIVISION <br /> <br />I <br /> <br />D NEW CONSTR D ADD/ALT 0 <br />0" INSTALL D REPAIR <br />PROPOSED USE 0" SFR D COMM 0 OTHER I <br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL D <br /> <br />DESCRIPTION OF WORK I J' 11 ..s(l-~'p / J' /.If fRIP. FEPf!;; - 3s' I' C t.IA/ jI/ L /lvl< ,. <br /> <br />BUILDING SIZE J"J(8 ' I SQ FOOTAGE I t. ~ .rp. HEIGHT I <br /> <br />PARCELlD#I/I. <br /> <br />I <br />2- 6p 2/ - Of) I () - 2/6d?J . C)O Go <br /> <br />LOT# I <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />'1....111....11......'...11...11...11'...111....,11...'"1.......11.....11....111...11....,11...111.......11...........11......111111...111111"111' <br /> <br />D BUILDING 1$ :I, (U>O -- I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E,C <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />'~ U ~\Q . <br /> <br />COMPANY <br />REGISTERED <br /> <br />'y\ 0 ",f\ e <br />I Y I N I <br /> <br />oW f\ey <br /> <br />FEE CURRENT I Y I N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />:>!Iqnd AllllO <br /> <br /> <br />:>!Iqnd AlllloN <br /> <br /> <br />WO~ <br /> <br />'uOIl~Ylluapl SIl ~, <br />'uOIl~Ylluapl SIl ~'J " ) paonpoJd aAIl4lSIl4 JO aw Ol UMOU)j ~lIlluoSJad aJllfS! 04M <br />pa~npojd aAB4/SIl4 JO aw Ol UMOU)j ~IIIlUosJad aJll/SI 04M \I 5 J crp V ~ "tI. CJ II :> ~ '1 ~q 9..0-f I ::::i <br />V 0 ,. ..r~ V \I.\J' li () I) 5 ~ ,~q g; -'i:: 1-> 0 SI4l aw aJ iaq (paWJ!lI1l JO) Ol WOMS pulf paq!J:>sqnS <br />, ~ ow..,..... (po"""..,) "I "'OMS puil>.q""""S ~ I,) 'I) "Tf1 0;;: !N'OV .0 ..HMO <br />....., ~;uAIIJ 1) ~ HOJ.:>Vl:IJ.NO:> <br />,-"r - - \l 1J 1 'J 0' ' (EO'H ~ 'S':I) J.'v'Hnr 'v'OIH01.:l <br />3HO:l38 A3NHO.llY NY HO H3CN31 HnOA HJ.IM <br />"l.N3W3:lN3WWO:l :10 3:l1J.~~__H!,,?~ :?~I.~~~~~~... unn1 n I ~ I N;lW3AO}ldWI HO:l 3:l1MJ. ONIAYd <br />